本文選題：冠狀動脈旁路移植術 + 紅細胞輸注��； 參考：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的目前對圍手術期輸注紅細胞是否會增加患者術后橋血管再狹窄的風險這一問題,學術界尚未有系統(tǒng)研究及詳細論述。本研究通過對比兩組術后患者橋血管通暢率,來對不停跳下冠狀動脈旁路移植術(off-pump coronary artery OPCAB)圍術期輸入紅細胞對于術后近期橋血管通暢率的影響這一問題,進行初步探討。方法選擇2013年6月至2015年6月在安徽醫(yī)科大學第一附屬醫(yī)院行OPCAB的127例(共127例,失訪21例,數(shù)據(jù)較完整106例)患者,依據(jù)患者圍術期紅細胞的使用與否分為兩組:組Ⅰ(輸注紅細胞組,71例);組Ⅱ(未輸注紅細胞組,35例)。所有選入患者,必須有同一手術者完成手術,并按照一定排除標準,排除不符合要求的病例。術前完善患者的臨床基礎資料,包括:年齡,身高,體重,高血壓,糖尿病,高血脂,吸煙史,家族史,左室射血分數(shù)(left ventricular ejection fraction LVEF),是否使用主動脈內球囊反搏輔助(Intraaortic Balloon Counterppulsation IABP)等資料,通過統(tǒng)計學方法進行分析。圍手術期觀測臨床資料包括:手術時間,術后停留ICU時間,呼吸機輔助呼吸時間,靜脈使用抗生素時間,住院天數(shù)及住院總費用。術后常規(guī)復查心電圖,胸片及心臟彩超等檢查。對其臨床資料進行分析。結果通過統(tǒng)計學方法進行統(tǒng)計分析,發(fā)現(xiàn)組‖橋血管通暢率高于組Ⅰ(P㩳0.05),并且組‖大隱靜脈(GVS)橋血管通暢率高于組Ⅰ(P㩳0.05),而兩組間左乳內動脈(LIMA)橋血管通暢率比較差異無統(tǒng)計學意義(P㧐0.05)。此外,通過對圍手術期臨床資料的對比分析,可以發(fā)現(xiàn)組Ⅰ停留監(jiān)護病房時間大于組‖(t=4.50,P=0),術后靜脈使用抗生素天數(shù)組Ⅰ長于組‖(t=4.21,P=0),住院費用(t=4.86)及住院總天數(shù)(t=6.54)組Ⅰ均高于組‖(P=0)。結論不停跳冠狀動脈移植術圍手術期輸血會加大近期大隱靜脈橋血管再狹窄的發(fā)生率,同樣也會增加術后近期橋血管再狹窄的風險。
[Abstract]:Objective at present, whether the perioperative transfusion of red blood cells will increase the risk of postoperative graft restenosis in patients has not been systematically studied and discussed in detail in academic circles. In this study, we compared the patency rate of graft vessels between the two groups, and discussed the effect of red blood cell infusion during off-pump coronary artery OPCAB) operation on the patency of graft vessels in the short term after coronary artery bypass grafting (CABG). Methods from June 2013 to June 2015, 127 patients (127 cases) who were treated with OPCAB in the first affiliated Hospital of Anhui Medical University, including 21 cases of missing visit and 106 cases of complete data, were selected. The patients were divided into two groups according to the perioperative use of red blood cells: group 鈪，

本文編號：1948882